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31 May 2015

In 2010 there was a law passed that means that only counsellors registered as an Adoption Support Agency and with Ofsted are able to offer specialist adoption counselling. This is an extract from a relevant page on the Counselling Directory website :Approved Adoption Counselling In December 2010, the law changed so that only counsellors and psychotherapists registered as an adoption support agency (ASA) with Ofsted are able to offer specialist adoption services.
These amendments to the Adoption and Children's Act of 2002 were designed to ensure that the one in four UK individuals affected by adoption in some way, are provided with support and services from practitioners who hold the proper qualifications and experience.
The introduction of this legislation now means that any counsellor working with a client for whom any aspect of adoption is the main focus, must be registered with Ofsted and subject to regular inspections. It may be that some individuals are seeking counselling for issues they feel may be related to adoption (such as low-self esteem) but where adoption is not the key issue. In cases such as these where the entire counselling experience is not likely to revolve solely around the adoption itself, it is fine to seek help from a professional who is not an Approved Adoption Counsellor. I am able to work with other issues that may be part of what is going on such as addictions or low self-esteem, but it is illegal for me to take on a client specifically with the purpose of working with the adoption issue itself.In my experience many counsellors are not aware of this legislation so please do ask anybody that you enquire with whether they are registered specifically with Ofsted and as an adoption support agency. If you would like specific, adoption counselling I would contact your local council Adoption Unit practice manager and ask if they can refer you to anybody suitably registered.I have happily worked with people affected by adoption issues but there has always been another presenting factor such as gambling, a personality disorder, trauma or relationship problems which has been the cause for seeking counselling.

24 May 2015

As a professional counsellor I often see
clients with issues around family break ups, affairs, problems with ongoing
divorce settlements and conflicts about children. These issues often leave
people feeling rejected and very vulnerable. Sometimes these issues can tap
into old wounds from childhood.

Divorce and separation involves loss for
both parties and is one of the most stressful things we can go through as
adults. A huge loss like this is akin to a bereavement and it is normal to
experience a range of emotions such as shock, denial, anger, guilt, sadness and
depression.

The shock is particularly present for those
who did not make the choice to separate and it can leave them feeling bewildered
and powerless as well as impacting on self-esteem. Guilt often haunts the person who makes the decision,
sometimes for years afterwards, even if the relationship was beyond repair.

Our emotions are there for a reason and we
need the opportunity to express them or we can end up stuck with them which can
in turn affect our future relationships or sense of happiness. We might not
always have the opportunitiesin
our personal lives to explore emotions without other people imposing their
agenda. There may be friends and family members who mean well, but we can feel
pressured to be feeling and behaving in a way that others expect of us, despite
the fact that grieving is a very individual process.

Some people are used to being the “strong”
or “responsible” one and do not feel comfortable sharing their difficulties
with anybody in their personal lives.

One of the ways which counselling works for
many people is that it provides the opportunity to talk about our inner world
of emotions.A good therapist will
help their client to explore what is lying behind symptoms such as depression,
anxiety or anger without imposing judgement or an agenda. In paying attention to
and understanding these difficult emotionsand how they might be tied up with judgements or beliefs
about ourselves we can be in a better place to move on.

There may have been relationship dynamics
present in the relationship which continue to play out post separation and
divorce. Perhaps one partner is perceived by the other as being controlling or
manipulative. Clearly there is a limit to what counselling can do to alter
somebody else’s behaviour but it can help people to have clearer boundaries and
feel more comfortable in asserting their own needs. If somebody has had a lifetime
of shelving their own needs then some coaching in assertiveness can really help
them.

Many people are pleasantly surprised at how
a different perspective from a trained and experienced counsellor can really
help them get on with life in a better place. It is well worth considering,
particularly if someone is struggling in the aftermath of a difficult
separation.

19 May 2015

This post is reblogged from The Not So Big Society Blog, written by Phil Doré, a mental health nurse with a niche interest in abuse by counsellors and psychotherapists.[PLEASE NOTE THAT IN REBLOGGING THIS PIECE AS A MATTER OF PUBLIC INTEREST I WAS SUBJECTED TO VARIOUS THREATENING EMAILS FROM RAY BOTT-HOLLAND. THIS IS WHAT I SENT IN RESPONSE:Dear Mr Bott-Holland

I write further to your email correspondence of 6th April 2018 and the many subsequent, unsolicited messages you have sent. I have sought legal advice and, as I suspected, there is no case for me to answer. I request that you cease communicating with me about this matter with immediate effect. If you persist in contacting me unsolicited I will have no option but to report you to the police for harassment.

Amanda Williamson]

Given that I’ve blogged about serious sexual misconduct cases in counselling and psychotherapy, @sameihuda on Twitter drew my attention to this article in BPS Research Digest. It deals with the tricky topic of when therapists develop a sense of sexual attraction to their clients.

The article refers only to when therapists have sexual feelings, not when this turns into actual sexual acts (fortunately, none of the therapists surveyed in the research cited had done this). I’ll give some thoughts on when this could happen.

Of those surveyed, 90 percent admitted to having felt attracted to a client on at least one occasion. I don’t think that’s particularly shameful. People feel attracted to other people all the time, including to people with whom it would be a seriously bad idea to actually try to take things further. Not just therapy clients; it could be your co-worker, or your best friend’s husband or wife. I’m sure there are far more occasions of it happening and people doing nothing than of times when people act on these thoughts. When this topic is discussed, professionals have a tendency to talk about transference and counter-transference, but for the life of me I can’t see why. It’s such an everyday, ordinary thing that it really doesn’t need any psychoanalytic concepts to explain it.

When this happens, I would hope that therapists would be honest with themselves about this, and in most cases they probably are. This is why psychotherapy training places so much emphasis on the therapist undergoing regular therapy and supervision – so you’re aware of what’s being brought from yourself into the room, and so you can learn to deal with what’s being brought in.

The research offers examples of both good and bad ways to respond.

Effective ways of coping involved the following processes, though not always in order: noting the attraction, which was often accompanied by feelings of anxiety or unease; facing up to the feelings, which often involved managing shame and embarrassment; reflecting on the attraction, including the relevance of the therapist’s own past; processing the feelings, including considering the implications of the situation; and finally formulating a way forward that would be to the client’s benefit.

Harmful ways of coping included: clumsily reinforcing therapeutic boundaries, which often left the client feeling rejected and to premature ending of therapy; taking a moralising or omnipotent stance, including implying that the client had inappropriate feelings; feeling needy (“… it seems inevitable that being single … you imagine those ‘what if’ questions, if we’d met elsewhere …”, said one male, middle-aged therapist); over-identifying with the client (one therapist talked of feelings of “yearning and anguish” after therapy ended; another spoke of being overwhelmed by a client’s pain and extending therapy sessions to cope); and finally responding with over-protective anxiety, including offering support that they didn’t usually offer, including allowing meetings between sessions, touch, hugging and sharing of personal information.

On the issue of clumsily reinforcing boundaries, this might be something to particularly consider if the therapist decides they need to pass the client on to a colleague. As a personal view, they should reflect on whether that actually needs to happen (which it doesn’t in all instances; and if it isn’t then it shouldn’t necessarily be rushed into as a decision). If it does need to happen, then it needs to be done in a careful, sensitive and non-rejecting way, so as not to harm the client.

Let’s move on to the question of when such thoughts and feelings (which, as I’ve said, I think are perfectly normal and not at all shameful), lead to actual actions, which by contrast would be the worst betrayal of a therapeutic relationship one could possibly commit. When does that happen?

I don’t have any research data to hand (if anyone knows of any, feel free to drop it into the comments section below) but anecdotal evidence seems to suggest that serious sexual misconduct doesn’t generally start with a perfectly normal session one week, and then the therapist and client having sex the next. More likely there’ll be other, lesser boundary breaches leading up to it.

revealing intimate details to a patient during a professional consultation

giving or accepting social invitations

visiting a patient’s home unannounced and without a prior appointment

seeing patients outside of normal practice, for example when other staff are not there, appointments at unusual hours, not following normal patient appointment booking procedures or preferring a certain patient to have the last appointment of the day other than for clinical reasons

clinically unnecessary communications.

These are behaviours that both professionals and clients should keep a careful eye out for.

Now let’s have a look at the personalities of some of the people I’ve written about on this blog. There’s Palace Gate, struck off as a counselling service by the BACP after its director John Clapham was found to have groomed trainee and subordinate counsellors within his firm. The company responded to the allegations in a manner more befitting a cult than clinicians. They still have on their blog a long, rambling, paranoid article full of psychobabble and accusing the complainants of waging a “battle between therapists”.

Or there’s Ray Holland, who was struck off by the UK Council for Psychotherapy for serious sexual misconduct with an “evidently vulnerable client.” The UKCP found that he “threatened [the client] in order to prevent her from reporting the matter” and “spoke with the absence of empathy towards [the client] whom he said he believed was ‘a fantasist’.” After he was struck off, I found that he had rebranded himself and carried on practicing. He cited membership of various impressive-sounding but non-accredited therapy organisations, and renamed himself Ray Bott-Holland.

There’s other cases, and by no means do I post online everything I’ve heard about every case. Some of what I’ve heard has been absolutely horrific. I remember receiving one account from a traumatised client, and not being able to get to sleep that night.

So, does this sound like the behaviour of ordinary professionals who behaved foolishly and got themselves out of their depth? No, it doesn’t. It sounds like the actions of highly dangerous and manipulative predators.

To conclude, I think it’s a normal thing for professionals to feel attracted to a client. However, if you’re a properly-trained, ethical therapist with good boundaries, it really isn’t difficult to not have sex with your clients.

On the other hand, psychotherapy is a profession where people sit in a room and hand over their darkest secrets and fears to another person. That gives the professional an enormous amount of power. With that in mind, one has consider the possibility that psychotherapy may be a very attractive career option to a psychopath.